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Zhang Xue Min
Vascular Surgery
About me
From 1988 to 1995, I studied at Beijing Medical University under the guidance of Professor Yan Zhongyu and Professor Li Tong, renowned experts in general surgery. I graduated with a master's degree in clinical surgery. From August 1995 to March 2001, I worked at the First Clinical Hospital of Beijing Medical University (Peking University First Hospital) in general surgery. In 2000, I studied peripheral vascular diseases under the mentorship of Professor Wu Qinghua, Professor Wang Weiliang, and Professor Huang Dexiang, renowned vascular surgery experts. From January to April 2001, I was responsible for vascular surgery at Peking University First Hospital. In April 2001, I transferred to Peking University People's Hospital and was one of the founding members of the vascular surgery department.
Proficient in diseases
Treatment of aortic and lower extremity artery intervention and surgery.
Voices
Can varicose veins be detected by ultrasound B?
Ultrasound is currently the main examination method for varicose veins. It is non-invasive, safe, and affordable, making it one of the standard methods for assessing varicose veins. Besides viewing the superficial veins, it also allows visualization of the deformed deep veins within the muscles, enabling a basic assessment of the causes of varicose veins. Ultrasound now plays a crucial role in the treatment of varicose veins. Many new treatment methods, such as blood flow modulation techniques like wrist flexing, require high precision in ultrasound use. It is essential to locate the reflux points using ultrasound, and then specifically target these points for ligation.
Why does varicose veins sometimes feel like needle pricks?
In cases of varicose veins, the blood flow in the varicose veins is relatively slow. This blood, having undergone gas exchange, contains less oxygen and more carbon dioxide. If such blood remains in a local area for an extended period, it can potentially stimulate the nerves to some extent. Sometimes, including in varicose veins, if the blood flow pressure within these veins increases, it can also stimulate the nerves in the outer membrane of the blood vessels, leading to abnormal nerve discharges. Such incidents can manifest as brief, pin-like pain, not particularly intense, resembling the sensation of a needle prick. This condition is quite common and generally holds no special significance.
Can varicose veins cause leg swelling?
Varicose veins are a broad concept that is clinically divided into seven grades, from 0 to 6. Grade 0 is normal, grade 1 involves some capillary dilation, grade 2 is marked by clear varicose veins, and from grade 3 onwards, edema can occur. Generally, the causes of varicose veins vary. Some people suffer from what is called simple superficial varicose veins, primarily due to problems with the valves in the superficial veins. These patients may experience mild edema, limited to the ankle area. Others suffer from secondary varicose veins, following dysfunction of the valves in the deep veins or communicating veins. In deep veins, there can be reflux or obstruction. In such cases, it is possible to cause compressible edema in the front of the lower leg, commonly known as shinbone area.
Can varicose veins occasionally be invisible?
When varicose veins are mild in their early stages, if you wear compression stockings during winter, it's possible that the varicosities are not very noticeable occasionally when you take off the stockings. However, in more advanced stages, when there are clearly widespread and clustered varicose veins, they are difficult to conceal. However, if deep vein thrombosis occurs, causing tissue edema, the swollen surrounding tissues may obscure the varicose veins, making them less visible. Therefore, we need to judge based on the specific circumstances. Generally, just because varicose veins are occasionally not visible does not mean that the condition has healed.
What are the effects of secondary surgery for varicose veins?
If varicose veins recur, we need to carefully investigate the cause of the recurrence and rule out problems in the deep venous system. If there is an obstruction in the deep veins, recurrence can occur quickly even after secondary surgery on the superficial veins. If the deep veins are only involved in venous reflux, surgery can still be performed, but it is hoped that medical compression stockings will be worn for a period of time after surgery. Otherwise, there is still a possibility of recurrence after the secondary surgery.
Is vein varicose treatment better with injections or surgery?
Venous sclerotherapy involves injecting a sclerosing agent and is a relatively good and minimally invasive treatment method. Its advantages include being minimally invasive and even suitable for outpatient surgery, with low costs. However, there are drawbacks; one is that the medication might enter the deep veins, causing deep vein thrombosis. If the dosage is too large, it could reach the lungs, causing pulmonary embolism. Additionally, the medication might seep into surrounding tissues, causing inflammatory reactions. Some patients may experience temporary hyperpigmentation. Surgical treatment is a more traditional method, but it depends on the specific situation. Generally, it causes more trauma than sclerotherapy and usually requires some level of anesthesia. Surgery entails a certain amount of blood loss, and like other methods, it cannot prevent recurrence.
How to treat varicose veins stage II?
If you're referring to the second stage of varicose veins, I'm not sure if you mean the clinical manifestation stage two, or if it's a recurrence after one surgery. Let's first talk about stage two varicose veins, which means there are visible and tortuous vein clumps. There are several main treatment methods for this condition: First, conservative treatment, which involves wearing medical compression stockings. If symptoms include soreness, heaviness, or cramping, some medications can be taken orally. Then, if there is a desire for surgical treatment, options like vein stripping, radiofrequency, or laser treatments are available. Some may involve sclerotherapy or another method called venous angle keratin treatment, specifically for stage two varicose veins. If it's a recurrence of varicose veins, we need to assess the specific situation. Some people might have had previous endovenous closure surgeries, and their veins are still present. In such cases, we can choose to redo the closure or opt for surgery to remove them. Another scenario is if the varicose veins have recurred after surgery. We need to investigate the cause. Some people might have iliac vein stenosis, and in such cases, treatment targeted at the iliac vein is necessary.
What happens if varicose veins worsen?
Varicose veins, when they worsen, can lead to changes in the skin, including thickening of the skin which feels woody to the touch. Additionally, the skin may exhibit pigmentation that can be severe enough to resemble the black color of a belt. More seriously, ulcers can develop, typically near the inner ankle, though they occasionally appear in other locations. These ulcers are referred to medically as “boot ulcers” and are commonly known among the general population as “continuous sore legs.” In extreme cases, these ulcers may persist for many years without healing and could potentially become malignant.